There are many physiotherapists, doctors, athletes and fitness trainers living with prolapse. Many continue to exercise regularly, play sport and compete. If you have recently been diagnosed with a prolapse, are peri or post menopause or have recently had a baby, then this is for you (either to manage your POP or prevent one).
An internal assessment with your Women’s health Physio will help you assess what degree your prolapse is, as well as what you are capable of currently, whether you should consider wearing a pessary during exercise and how your PF is functioning, such as establishing your base line strength.
There is so much information about what you can’t do with POP but there is not a great deal of information on what exercises you CAN do and HOW you do them. So, I’ll be addressing all that you can do and the strategies you need to manage your POP so you can continue exercising for life.
Benefits of Exercising for Prolapse
Exercising is your best form of prolapse rehab and management. Exercise benefits your POP in many ways such as:
Managing and reducing weight gain that contributes to straining of the PF muscles
Assists in an easier delivery for those who are pregnant and smooth postpartum recovery
When done correctly, prioritises deep core & pelvic floor function by optimising breathing, alignment, relaxation and integration – this in turn strengthens the PF muscles and prevents further weakness
improves quality of life by teaching correct strategies for everyday life (such as lifting and carrying children, shopping etc)
Exercise can even help treat constipation and promote healthy digestion thus negating the urge to strain on the toilet.
There is only so much that can be achieved with pelvic floor exercises. Pelvic floor muscle training however, includes functional exercises with the PF lift & relaxation (at the right times) integrated into the movement. This is something that is not usually taught in fitness centres to women who have recently had a baby, are pregnant or are peri or post menopause or to women who have had gynaecological surgery (eg. hysterectomy). It also paves the way for you to return to sports, higher intensity exercise and more dynamic activities.
So if you type search this sentence into google search engine, you will see
Where do you start? The first 10 pages are mainstream news articles and celebrity fitness trainers who now have a worldwide platform to exploit the anxieties and fears of the Mums.
The problem with these articles is the thought that a specific exercise is the solution to getting our pre baby bodies back or fixing Disatasis recti, pelvic floor weakness, incontinence, and back pain etc.
The other problem is that many view exercising as a means to an end, (usually an aesthetic goal) rather than enhancing their quality of life.
The fitness industry has become obsessed with aesthetics, supplements and trends. Social media is evolving the fitness industry right before our eyes with fake influencers, endorsements & fame-hungry fitness “stars”. So what do you think? Is there a specific exercise or exercise modality that will fix your postpartum body or keep you looking sexy during pregnancy?
The first answer to this question reminds me of one of the themes that is floating around in the pelvic health world is not which exercise is best, but how it’s being done. As Julie Wiebe puts it, “Which strategy are you using?” These strategies encompass analysing things like:
How are you controlling internal pressures?
Are you holding your breath?
What is your posture like during the exercise?
Have you reconnected with your pelvic floor and TA or are you keeping that connection strong during pregnancy?
Are your glutes functioning well?
Are you gripping your pelvic floor or obliques?
What other compensation patterns are you using?
What is your exercise history?
What is being said here is that there is no one size fits all approach. I have seen this many times in the Pilates world. Pilates is often promoted as a “safe” postnatal exercise modality, however Pilates is an intense abdominal workout, and if you’re someone who holds their breath, has poor posture and can’t connect well with their TA muscle then you are probably bearing down on your pelvic organs (can lead to pelvic organ prolapse and incontinence), or over straining your abdominal wall (ending in a hernia) then Pilates is not going to be for you! (yet).
Pelvic floor exercises or Kegels are another popular recommendation. But should we really be recommending these to anyone if we do not have the consent from her pelvic physiotherapist? Something that may surprise you is that pelvic floor exercises may actually make some women’s symptoms worse. Non relaxing pelvic floor disorder is not widely recognised yet. These women need to “down train” the pelvic floor which involves relaxation of the pelvic floor muscles rather than contracting them.
Secondly, by believing there is a magic exercise we forget the point of why we need to exercise. When I started in the fitness industry, there was no such thing as smart phones or social media. Heck it was so uncool to wear your gym clothes outside of the gym! Now it’s practically a luxury fashion statement!
So what should be the reason we exercise during pregnancy and after birth? Is to land a insta famous fitness contract? or be featured in the body transformation page on Kayla Istines? No. It should enhance our life and health, not hinder it.
How do we enhance our precious energy and health during these chapters of life?
In recent years, Aerobic workouts have been given a bad rap. But they are extremely important for overall fitness for everyone from a sedentary stay at home mum to your powerlifting fit mum. Aerobic exercise is moderate intensity exercise that uses oxygen as its primary fuel source. The aerobic system is our life system. We are predominantly (99%) in this system throughout our life! It is the system that keeps us going and breathing and living day in day out.
Aerobic exercise increases cardiovascular fitness, increases the time to fatigue, burns fat, and promotes recovery in muscle tissue. But something is happening at an even deeper level than that. Have you every wondered why you feel like you have more energy the more you exercise? It’s because aerobic training helps our cells (mitochondria) make energy (ATP) more efficiently. Aerobic exercise uses oxygen, which directly relates to how the mitochondria function. The more oxygen you pump to your muscle cells and their mitochondria through aerobic workouts, the faster and better they work to produce energy.
And… we don’t just get these benefits in our muscles. We have mitochondria in our brain, liver, heart and so on. So aerobic exercise improves our overall health, our energy, and even our mood as a pose to high intensity exercise – that which is particularly stressful to the body. The production of energy (ATP) via the anaerobic system (it is the same as the fight or flight system) causes high levels of fatigue and cortisol. As a new or pregnant mum, would more stress in your life during pregnancy and postpartum be a good thing?
Aerobic exercise is also linked with slowing down the ageing process. (Mitochondria decay that occurs with age cannot be counteracted unless physical activity is enhanced.)
So, what is aerobic exercise?
Without getting too nerdy on you, It should be moderate intensity long duration (longer than 30 mins) exercise that you are still able to hold a conversation during , however your breathing, body temp and heart rate must be elevated. For aerobic exercise to beneficial in the ways mentioned above, it should be undertaken 2- 3 or more times per week during these chapters of life. Some great forms for pregnancy and postpartum are:
cycling (flat road, light gears, seated)
For more on why I don’t recommend running during this time of life see this post.
And remember, its how you’re doing these exercises too! What strategies are you using?
Meet Jade, she is currently in her third trimester and is pregnant with twins. Jade was a regular cross fitter until she fell pregnant. She wanted to continue exercising and stay strong during pregnancy but naturally, growing two babies really took it out of her in the first trimester, so she didn’t end up doing alot of movement.
She also started noticing coning in her abs from a very early stage, so she began training with me. There’s nothing we can do to prevent Diastasis Recti in pregnancy (especially with twins!) but there’s HEAPS we CAN do to reduce the severity of it. Pregnancy is her pre-hab!
We also try to keep up her high level of conditioning with things like battle ropes, assault bikes and low impact cardio. To maintain her strength yetreduce the chances of pelvic floor, abdominal and/or back issues (did I mention this super woman is going to deliver her twins naturally?!) we take classic Crossfit movements and workouts & modify the depth, the range, the reps, sets & the load where we need to and incorporate the piston breath into EVERYTHING. We also focus a lot on maintaining her strong glutes to compliment pelvic floor strength, reduce injury to her hips and improve lower body strength. This approach is all ABOUT adaptable training and movement strategies – telling women to “LISTEN TO YOUR BODY” “DO WHAT YOU’VE AWAYS DONE!” “IF YOU WORKOUT YOU’LL BOUNCE BACK!” in pregnancy is downright dangerous. No joke. On the other end of the spectrum, Trainers who are making women scared to pick up a dumbbell during pregnancy is not DUTY of CARE. It’s not preparing her for the biggest physical event of her life – BIRTH!
Having a good background in fitness there’s so muchJade can still do up until late in her third trimester. However, every woman’s exercise experience, circumstances, goals and abilities vary from person to person. For information on how to continue crossfit during (and after) pregnancy click the link below!
Meet Christine. She is postpartum by 3.5years. Her testimonial is more proof that postpartum IS Much longer than the 4th trimester – or first 6 weeks postbirth!
” After having Annabelle (now 3) and getting used to the pace of life with 3 young girls to look after, I realised I needed to get back into some regular excursive for my own mental health & sanity! So I started looking for a group to train with near Newport. I was looking for a knowledgeable trainer, relaxed / social / supportive group atmosphere, and training outdoors – I love to get some fresh air.
Real Fitness for Mums, met these criteria and more. About 12 months after having my daughter, my GP had given me a referral to a “Women’s Physio” specialising in pelvic floor issues, but it all seemed too hard / awkward so I never went. Before my 1st session with Real Fitness for Mums, Ali forwarded a comprehensive health / fitness questionnaire, and when we met she asked me a few more questions, and suggested I see a Women’s Physio before starting any sort of medium / high impact exercise. This was the gentle push in the right direction I needed.
Ali was able to start me off on modified exercises so I could go at my own pace building strength in my pelvic floor & core, before moving onto higher impact and weight barring challenges. It took me a few weeks (and a lot of pelvic floor training) to be able to mentally connect my breathing, pelvic floor, and coordination to exercise. It was a little bit frustrating having to start off slowly, but Ali has been really supportive & encouraging each session, as were the other women in the group.
Real Fitness for Mums is perfect for any mum looking to exercise. Ali’s knowledge, experience, and passion for helping mums regain their strength and fitness really shine through in every session. The classes are small and every exercise is personalised to your level. For me the class times also worked well after dropping 2 children at primary school. There’s even a babysitter at Thursday mornings sessions so my 3 yr old has an excellent time playing safely in the park, whilst I can focus on me for an hour”.
To book a FREE trial session please email ALI firstname.lastname@example.org
Term 2 2019 Upcoming for OUTDOOR Group Fitness and Movement for Mums
This week marks the final classes for term 1! If you would like to join the classes this term we added an extra evening class and a Saturday Morning class which are appealing to many because it can mean KID FREE time!
We use a variety of equipment and disciplines such as resistance training, body weight training, cardio, pilates, kettlebells to teach you the strategies that will set you up for life to remain injury free, healthy and fit.
The class is designed to help your body heal from pregnancy and birth, and improve your quality of life, whether it’s doing the chores at home, playing games with your kids, or returning to sports, running, weight training or what ever form of athleticism you enjoy by equipping you with all the tools you need to heal and remain injury free for life. – Come and try us out!
Click the link below to discover the times and locations and to sign up for the Term.
Our very first adventure for women and mums happened last sunday and it was a great success! Some much needed “me time” was enjoyed by these mums and not only that but we spent 2hours in the beautiful autumn sunshine. Did you know that most of people spend less time outdoors each day than prison inmates!? Sunshine and being in nature is proven to calm the soul, improve the immune system, increase Vit D levels, Gut bacteria diversity and increase longevity. Plus it is FUN! Win win!
Come hang with some like minded gal pals for an easy, beginner based adventures. They will be running approximately once per month – ranging from mountain biking, hiking, kayaking and surfing. Oh and hey, they are completely free! Stay tuned via the facebook page and I have started an adventures page on Instagram (@realfitnessadventures).
I am also excited to be presenting at the next Women’s Health Charity Event in Mona Vale on Saturday May 18th.
I will speaking and presenting my experience and advice regarding exercising with prolapse! YAY. If you are pregnant, postnatal, female or menopausal … .then this event is for you! Other topics that will be discussed are:
Women’s Health Physiotherapy- Understanding your Pelvic Floor, dealing with incontinence and Prolapse
Fitness and Bone Health
Anxiety and Emotional Well-being
Career and Purpose and more.
To book your FREE spot please email email@example.com
And just like that, 2018 is over! 2018 has been a rollercoaster ride, ups and downs, adventures, new friends, old friends, new clients, new jobs and a lot of growth for me personally, academically, spiritually and physically. I am stoked that I am now comfortable with both wheels off the ground, I’ve reached a new peak in my fitness and POP symptoms are virtually zero!
I have lots of exciting things planned for 2019. I hope you all have an amazing 2019 (and beyond) and reach your full potential in all areas of your life. I want to encourage you to continue with your health and fitness goals and support you on your adventures too. Thank you all for following and supporting me! Everything (excluding face to face training) is discounted by a huge 20% until 2nd Jan 2019! Use the code “boxingday” in the cart.
Could this be one of the million dollar questions in the fitness industry …….?! What do you think the best exercise is for you? Is it core exercise? Is it running a marathon? How about lifting weights? The answer is going to surprise you! But first, lets explore what others are saying – and what is NOT the best exercise for Mums.
Every magazine, mummy blog, motherhood instagram page and fitness guru promote many different opinions, (which are usually either endorsed or biased) and largely promote high intensity exercise such as tabata or HIIT as the best choice.
Sure, this type of training can be short in duration which suits and appeals to time poor mums. “Get fit in 7minutes a day!”, ” Tone your abs and lose the baby weight in 6 weeks!” are very attractive sentences to mums. In my experience, The first thing my client’s want to do is ‘smash’ their body after they have a baby, because they think that is what is going to make them “get their body back” and contribute to their sanity and self confidence. BUT – their bodies are already “smashed” due to sleep debt, pregnancy and breastfeeding hormones, birth trauma and other stresses of life. The last thing they should be doing is smashing it in the gym. (I’ve written plenty of posts about this regarding pelvic floor health, but this post is going on a slightly different tangent).
Most would agree (whether your’e a mum or not) that being a mum is stressful. That we’re often already running on high levels of cortisol and are in constant fight or flight syndrome. This is due largely to sleep debt, and the constant role of looking after a newborn and / or older kids. Money is often a big concern and relationship issues can also develop due to the lack of time and energy needed to devote to each other.
My problem with chronic high intensity exercise with little focus on restorative and aerobic (low intensity, longer duration) exercise is that it over uses the anerobic energy system. This energy system is basically an emergency system for when we are (or were) in danger and it is the same as the Fight or Flight system. When this system is overly taxed, it puts an extra strain on the nervous system, joints and muscles, encourages fat storage, muscle loss, sleep problems, and injuries.
This Chronic strain on the nervous system contribute to increased cortisol (stress hormone) levels. Cortisol promotes fat storage, increases the risk of type 2 diabetes, cardiovascular disease, and other things. A 2017 study published in the American Journal of Medicine found instances of a condition called rhabdomyolysis – the breakdown of muscle – among new High Intensity Interval Training fans.
If you are a new mum, or sedentary (and what new mum doesn’t spend the majority of her life sitting or lying down with a little one in her arms) the strain on the joints and muscles are increased. Your joints and muscles are weakened during pregnancy due to hormones and posture changes, not to mention again birth trauma (forceps delivery and c-sections are the worst for ligament and nerve damage). If you are breastfeeding this risk is increased again.
Finally, there there is not a lot emphasis on quality of movement, mobility, activation, or internal balance in high intensity exercise programming. This leads to injuries. It’s all about doing a move as heavy and/or as quickly as you can. Activation and mobility are extremely important elements in anyone’s fitness program but MOST importantly, in Mums’ programming. After pregnancy and birth, women need to retrain the brain using their breathing to re- activate the deep core and the pelvic floor muscles. They also need a degree of pelvic floor mobility, as well as hip, spine and so on. And quality of movement I think speaks for itself?!
This internal balance (Homeostasis) mentioned above is the steady state of equilibrium in the body, between all internal conditions and elements such as temperature, fluid/electrolyte balance, energy production and utilisation and so on. When an already overstressed and under rested person undertakes regular high intensity exercise, they often make it harder for the processes in the body to achieve this balance. Think of the term “wellness”. Homeostasis is also important for the natural onset and progression of labour.
So the Million Dollar question – What is the best exercise for you, Mumma?
Answer: ” The best exercise is one that you enjoy”. – Dr Robert Sapolsky.
Why is this?
If you enjoy your exercise choice, without over stressing your anerobic system you will produce endorphins, benefit your nervous system, sleep better, improve your immune system (gut bacteria is increased via exercise), and achieve a steady state of homestatsis (internal balance). Whether you prefer outdoor group fitness, personal training, gym memberships or online/home workouts, I have options for all these on my web site.
a body transformation is only a great one if it is sustainable long term!